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中国武汉 109 例 COVID-19 肺炎逝者的住院和重症监护情况

Hospitalization and Critical Care of 109 Decedents with COVID-19 Pneumonia in Wuhan, China.

机构信息

Department of Respiratory and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China.

Department of Respiratory and Critical Care Medicine, Tianyou Hospital Affiliated with the Wuhan University of Science and Technology, Wuhan, China.

出版信息

Ann Am Thorac Soc. 2020 Jul;17(7):839-846. doi: 10.1513/AnnalsATS.202003-225OC.

Abstract

The current outbreak of coronavirus disease (COVID-19) pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China, spreads across national and international borders. The overall death rate of COVID-19 pneumonia in the Chinese population was 4%. To describe the process of hospitalization and critical care of patients who died of COVID-19 pneumonia. This was a multicenter observational study of 109 decedents with COVID-19 pneumonia from three hospitals in Wuhan. Demographic, clinical, laboratory, and treatment data were collected and analyzed, and the final date of follow-up was February 24, 2020. The mean age of 109 decedents with COVID-19 pneumonia was 70.7 years, 35 patients (32.1%) were female, and 85 patients (78.0%) suffered from one or more underlying comorbidities. Multiple organ failure, especially respiratory failure and heart failure, appeared in all patients even at the early stage of disease. Overall, the mean time from onset of symptoms to death was 22.3 days. All 109 hospitalized patients needed admission to an intensive care unit (ICU); however, because of limited availability, only 51 (46.8%) could be admitted. The period from hospitalization to death in the ICU group and non-ICU group was 15.9 days (standard deviation = 8.8 d) and 12.5 days (8.6 d,  = 0.044), respectively. Mortality due to COVID-19 pneumonia was concentrated in patients above the age of 65 years, especially those with major comorbidities. Patients who were admitted to the ICU lived longer than those who were not. Our findings should aid in the recognition and clinical management of such infections, especially with regard to ICU resource allocation.

摘要

目前在中国武汉发生的由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的冠状病毒病(COVID-19)肺炎已跨越国界。中国人群 COVID-19 肺炎的总体死亡率为 4%。描述死于 COVID-19 肺炎的患者的住院和重症监护过程。这是一项对来自武汉三所医院的 109 名 COVID-19 肺炎死亡患者的多中心观察性研究。收集并分析了人口统计学、临床、实验室和治疗数据,随访的最终日期为 2020 年 2 月 24 日。109 名 COVID-19 肺炎死亡患者的平均年龄为 70.7 岁,35 名患者(32.1%)为女性,85 名患者(78.0%)患有一种或多种基础合并症。多器官衰竭,尤其是呼吸衰竭和心力衰竭,在疾病早期即出现在所有患者中。总体而言,从症状发作到死亡的平均时间为 22.3 天。所有 109 名住院患者均需要入住重症监护病房(ICU);然而,由于 ICU 床位有限,只有 51 名(46.8%)患者可以入住。ICU 组和非 ICU 组从住院到死亡的时间分别为 15.9 天(标准差=8.8 d)和 12.5 天(8.6 d,P=0.044)。COVID-19 肺炎的死亡率集中在 65 岁以上的患者,尤其是患有重大合并症的患者。入住 ICU 的患者比未入住 ICU 的患者存活时间更长。我们的发现应有助于识别和临床管理此类感染,特别是 ICU 资源分配。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eda2/7328178/f82d38abcfbb/AnnalsATS.202003-225OC_f1.jpg

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